Potential Adjunct Therapy for Allergic Cats

In the Literature

Noli C, della Valle MF, Miolo A, Medori C, Schievano C, The Skinalia Clinical Research Group. Effect of dietary supplementation with ultramicronized palmitoylethanolamide in maintaining remission in cats with nonflea hypersensitivity dermatitis: a double-blind, multicentre, randomized, placebo-controlled study. Vet Dermatol. 2019;30(5):387-e117.

The Research …

Few options are available for the treatment of feline allergic dermatitis; this may be due to the fact that feline hypersensitivity dermatitis is generally less understood as compared with its canine counterpart, atopic dermatitis. Palmitoylethanolamide (PEA) is a lipid compound that has anti-inflammatory effects and acts by downregulating many of the cells involved in the allergic response (eg, cutaneous mast cells, T cells, keratinocytes, macrophages). This study* investigated the use of ultramicronized PEA (PEA-um) in cats with non-flea–hypersensitivity dermatitis.

Fifty-seven cats were initially enrolled in this double-blind study, but only 25 met all requirements for analysis. Cats received a 28-day tapering course of methylprednisolone and were assigned to either the PEA-um group or the placebo group; PEA-um (15 mg/kg PO every 24 hours) or placebo was administered for 12 weeks. Cats were assessed throughout the study through the use of an owner-reported visual analog scale and global assessment score, as well as a clinician-reported validated score for assessment of skin lesion extent and severity. Cats receiving PEA-um had lower pruritus scores as compared with placebo-treated cats both when steroids were stopped and when a flare was noted following steroid cessation. In addition, cats that received PEA-um had a significantly longer time until relapse following steroid cessation (mean, 40.5 days as compared with 22.2 days in the placebo group). In the PEA-um group, 33% of owners reported that there was no worsening of their cat’s condition following steroid discontinuation, an observation not noted by any owners of placebo-treated cats.

*This study was funded by Innovet Italia Srl.

… The Takeaways

Key pearls to put into practice:

• Allergy management requires a multimodal approach. No single treatment will work perfectly for all allergic patients. There are fewer therapeutic options available for cats, so new options are needed. PEA-um is a promising potential tool for allergy management in cats.

• PEA-um should be used primarily as an adjunct therapy to other treatments. This study suggests that PE-um has a steroid-sparing effect; however, further research is needed.

• PEA-um is available in the United States as a soft chew for dogs. This study used a liquid form, which is not commercially available in the United States.